Nightingale, the award-winning overall design from gravitytank based in Chicago, Il., allows patients to print portions of their records, including tips on how to improve their results. Image courtesy of gravitytank

Graphic designers re-imagine the patient portal

■ The Office of the National Coordinator hopes a more visually appealing and accessible product will encourage additional users to download their medical records.

Believing a graphic designer's eye could help make the patient record easier to use, the Health and Human Services Office of the National Coordinator for Health Information Technology and the U.S. Dept. of Veterans Affairs launched a contest aimed at redesigning the VA's text-only patient record. They hope the ideas generated from the contest will inspire other developers to take similar approaches to their own products.

The VA's MyHealtheVet portal allows patients to access, download and print their medical records through what it calls the blue button. Comparing the text-only blue-button document to a cash register receipt, Ryan Panchadsaram, the ONC's presidential innovation fellow, said the records need to be easier to use so patients, their family members and their care teams can be empowered by what they find.

A look at the VA’s current text-only patient records. Photo courtesy of U.S. Department of Veterans Affairs

The ONC has had a particularly strong focus on improving patient engagement by making it part of the criteria for qualifying for Medicare and Medicaid meaningful use incentives. Physicians applying for stage 2 of meaningful use must ensure that at least 5% of patients download their records from an online portal.

Since the blue button's debut in 2010, other organizations have embraced the concept and launched blue buttons of their own. And because of meaningful use, the concept is expected to continue growing. The ONC wants to ensure that patients are using the information in the records to make better decisions and improve their health.

The ONC and VA announced its contest in October 2012. The final design, which may include aspects from several entries, will be made available on the code-sharing site Github for other vendors to integrate into their products.

“Graphic designers have the unique ability to take something that exists, transform it, and make it more valuable and usable,” Panchadsaram wrote in an October blog post announcing the patient record contest.

Winners announced

In January, the winning designs were chosen from more than 230 entries. Three were selected for best overall design. Other entries were awarded for categories such as best medication design and best lab design. The ONC created an online gallery of the winners as well as other entries that “challenged the status quo.”

The first-place prize for best overall design went to gravitytank, a Chicago design firm. In its presentation, the developers said patients have acted as “couriers, bringing our records from one doctor to another without understanding what's in them.” They said the records have provided pages of “impersonal stats” and “lists full of demographics, medical terminology and legal jargon that make us feel like lab specimens rather than unique individuals.” Their redesign focused on making the record dynamic, holistic, understandable and personalized.

The winning design, Nightingale, allows patients to print portions of their records, including test and lab results, which are presented with tips on how to improve the results. Alerts also can be sent to a patient's phone for medication and appointment reminders as well as prompts for such activities as going for a walk.

The final design the ONC will use for the blue-button system has not yet been revealed. Once it is, the VA may use it to improve its patient portal, My HealtheVet, where veterans can access the blue button.